scholarly journals A Qualitative Study of Organisational Response to National Quality Standards for 7-Day Services in English Hospitals

2020 ◽  
Author(s):  
Elizabeth Sutton ◽  
Julian Bion ◽  
Russell Mannion ◽  
Janet Willars ◽  
Elizabeth Shaw ◽  
...  
Keyword(s):  
Poor Performance ◽  
Organisational Culture ◽  
National Standards ◽  
Local Context ◽  
Structured Interviews ◽  
Improvement Strategy ◽  
Senior Staff ◽  
National Quality ◽  
History Of ◽  
The Impact

Abstract Background National standards are commonly used as an improvement strategy in healthcare, but organisations may respond in diverse and sometimes negative ways to external quality demands. This paper describes how a sample of NHS hospital trusts in England responded to the introduction of national standards for 7-day service (7DS), from an organisational behaviour perspective. Methods We conducted 43 semi-structured interviews with executive/director level and clinical staff, in eight NHS trusts that varied in size, location, and levels of specialist staffing at weekends. We explored approaches to implementing standards locally, and the impact of organisational culture and local context on organisational response. Results Senior staff in the majority of trusts described a focus on hitting targets and achieving compliance with the standards. Compliance-based responses were associated with a hierarchical organisational culture and focus on external performance. In a minority of Trusts senior staff described mobilising commitment-based strategies. In these trusts senior staff reframed the external standards in terms of organisational values, and used co-operative strategies for achieving change. Trusts that took a commitment-based approach tended to be described as having a developmental organisational culture and a history of higher performance across the board. Audit data on 7DS showed improvement against standards for most trusts, but commitment-focused trusts were less likely to demonstrate improvements on the 7DS audit. The ability of trusts to respond to external standards was limited when they were under pressure due to a history of overall poor performance or resource limitations. Conclusions National standards and audit for service-level improvement generate different types of response in different local settings. Approaches to driving improvement nationally need to be accompanied by tailored support for improvement that takes into account local context and organisational culture.

scholarly journals A qualitative study of organisational response to national quality standards for 7-day services in English hospitals

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizabeth Sutton ◽  
Julian Bion ◽  
Russell Mannion ◽  
Janet Willars ◽  
Elizabeth Shaw ◽  
...  
Keyword(s):  
Organisational Culture ◽  
National Standards ◽  
Local Context ◽  
Structured Interviews ◽  
Improvement Strategy ◽  
Senior Staff ◽  
National Quality ◽  
History Of ◽  
Day Services ◽  
The Impact

Abstract Background National standards are commonly used as an improvement strategy in healthcare, but organisations may respond in diverse and sometimes negative ways to external quality demands. This paper describes how a sample of NHS hospital trusts in England responded to the introduction of national standards for 7-day services (7DS), from an organisational behaviour perspective. Methods We conducted 43 semi-structured interviews with executive/director level and clinical staff, in eight NHS trusts that varied in size, location, and levels of specialist staffing at weekends. We explored approaches to implementing standards locally, and the impact of organisational culture and local context on organisational response. Results Senior staff in the majority of trusts described a focus on hitting targets and achieving compliance with the standards. Compliance-based responses were associated with a hierarchical organisational culture and focus on external performance. In a minority of trusts senior staff described mobilising commitment-based strategies. In these trusts senior staff reframed the external standards in terms of organisational values, and used co-operative strategies for achieving change. Trusts that took a commitment-based approach tended to be described as having a developmental organisational culture and a history of higher performance across the board. Audit data on 7DS showed improvement against standards for most trusts, but commitment-focused trusts were less likely to demonstrate improvements on the 7DS audit. The ability of trusts to respond to external standards was limited when they were under pressure due to a history of overall poor performance or resource limitations. Conclusions National standards and audit for service-level improvement generate different types of response in different local settings. Approaches to driving improvement nationally need to be accompanied by resources and tailored support for improvement, taking into account local context and organisational culture.

scholarly journals Prevalence of musculoskeletal conditions and related disabilities in Bangladeshi adults: a cross-sectional national survey

2020 ◽  
Author(s):  
Ahmad Zahid-Al-Quadir ◽  
Mohammad Mostafa Zaman ◽  
Shamim Ahmed ◽  
Mahfuzur Rahman Bhuiyan ◽  
Md Mujibur Rahman ◽  
...  
Keyword(s):  
Adult Population ◽  
Frozen Shoulder ◽  
Health Assessment ◽  
Formal Schooling ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Physical Trauma ◽  
Soft Tissue Rheumatism ◽  
History Of ◽  
The Impact

Abstract Background: The objective of this study was to determine the prevalence of musculoskeletal (MSK) conditions and related disabilities in the adult population of Bangladesh because was no nationally representative data. Methods: A total of 2000 individuals aged 18 years or older were targeted where 1843 (92.1%) participated from 20 primary sampling units (urban and rural) of all former seven divisions of Bangladesh in 2015. Structured interviews were done using the modified Community Oriented Program for Control of Rheumatic Disorders questionnaire to detect positive respondents. Standard criteria were used for diagnosing MSK conditions by rheumatology residents. In case of uncertainty, opinion was taken from senior rheumatologists. A Bangla version of the Health Assessment Questionnaire was used to determine disability. Results: Among the respondents, 892 men and 951 women participated from rural (n=716) and urban (n=1127) areas. Their mean age was 40.5 (standard deviation 14.7) years. Almost a third did not have any formal schooling. Overall, 30.4% (95% confidence interval, 28.3-32.5) had MSK conditions. Low back pain (18.6%, 16.9-20.5), knee osteoarthritis (7.3%, 6.1-8.5) and soft tissue rheumatism 3.8% (2.9-4.7) were the three top-ranking MSK conditions. Rheumatoid arthritis (1.6%, 1.0-2.1), spondyloarthritis (1.2%, 7-1.8) and frozen shoulder (1.4%, 0.9-1.9) were relatively uncommon. Among those who had rheumatic disorders, 24.8% (21.3-28.6) had some degree of disability. Of them, 24.4% (21.0-28.1) had history of work loss during last 12 months. Being overweight, having history of physical trauma and diabetes mellitus, age and female sex were positively but education was negatively associated with MSK disorders. Conclusions: The high burden of MSK conditions and related disabilities in Bangladesh is high. Further studies are needed to estimate the impact of this group of disorders particularly addressing YLD, quality of life and economic consequences.

‘Slow to change’: Farmers’ perceptions of place-based barriers to sustainable agriculture

2017 ◽  
Vol 32 (6) ◽  
pp. 511-523 ◽  
Author(s):  
Samantha Grover ◽  
Joshua Gruver
Keyword(s):  
Smallholder Farmers ◽  
Ecological Factors ◽  
Past Research ◽  
Qualitative Inquiry ◽  
Local Context ◽  
Small Scale ◽  
Agricultural Policies ◽  
Structured Interviews ◽  
Regional Factors ◽  
The Impact

AbstractSmallholder farmers are an important and growing segment of the farm population in Indiana and in the USA. Past research regarding farmer decision-making has been inconsistent and has largely focused on the larger-scale, conventional farmer, leaving smallholders poorly understood. There is a need to better understand the management decisions of smallholder farmers within their regional context to promote efforts toward environmental, social and economic sustainability. Through in-depth qualitative inquiry, this study investigated the impact of regional factors that influence farmers’ decisions and the barriers and opportunities most relevant to farm viability and sustainability in the context of East Central Indiana (ECI). Semi-structured interviews with 15 key informants and 33 farmers informed our understanding of the factors most relevant to small-scale farming in the region. Several important themes emerged related to perceived barriers to sustainable farm management, including markets; structures and regulations; time and labor; environmental/ecological factors; and networking and access to educational support. The results of this study complement the findings of previous work that describe the complex framework farmers navigate when making decisions on the farm. Further, subtle regional factors emerged that significantly impact farmers’ decisions, emphasizing the importance of local context in crafting agricultural policies and outreach efforts. Implications and recommendations for ECI are discussed.

Does a course on the history and philosophy of chemistry have any effect on prospective chemistry teachers’ perceptions? The case of chemistry and the chemist

2017 ◽  
Vol 18 (4) ◽  
pp. 601-629 ◽  
Author(s):  
G. Sendur ◽  
M. Polat ◽  
C. Kazancı
Keyword(s):  
Prospective Teachers ◽  
Retention Test ◽  
State University ◽  
Structured Interviews ◽  
Philosophy Of Chemistry ◽  
Chemistry Teachers ◽  
Teachers Perceptions ◽  
Post Test ◽  
History Of ◽  
The Impact

The creative comparisons prospective chemistry teachers make about “chemistry” and the “chemist” may reflect how they perceive these concepts. In this sense, it seems important to determine which creative comparisons prospective teachers make with respect to these and how these can change after the history of chemistry is treated in the classroom. This study seeks to investigate the impact of the basic History and Philosophy of Chemistry course on prospective chemistry teachers’ perceptions towards chemistry and the chemist. The study was conducted during the 2012–2013 academic year at a state university in Turkey with 38 prospective chemistry teachers. A creative comparisons questionnaire and semi-structured interviews were used as data collection instruments in the study. This questionnaire was administered to the prospective teachers in the form of a pre-test, post-test, and retention test. Results of the analysis showed that the prospective teachers produced creative comparisons related to chemistry in the pre-test that mostly relied on their own experiences and observations, but that in the post-test and retention test, their comparisons mostly contained references to the role of chemistry in daily life, its development, and its facilitating aspects. Similarly, it was observed that in the pre-test, the prospective teachers made creative comparisons regarding the chemist that related mostly to the laboratory, but that the post-test and retention test rather contained the aspects of chemists as researchers, meticulous persons, facilitators and managers. Also, 18 prospective teachers were engaged in interviews to understand their prior knowledge about chemistry and the chemist, as well as the reasons for the changes in their creative comparisons. The results of the interviews indicated that a large majority of the prospective teachers were able to fully reflect on their inadequacy about their previous knowledge about “chemistry” and “chemist,” and it was seen that they could explain the reason they changed their creative comparisons as an outcome of the History and Philosophy of Chemistry course. In the light of these results, it can be said that the History and Philosophy of Chemistry course may help prospective chemistry teachers in their perceptions about both chemistry and the chemist and may add depth to their knowledge.

scholarly journals Effects of ketamine treatment on suicidal ideation: a qualitative study of patients’ accounts following treatment for depression in a UK ketamine clinic

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029108 ◽  
Author(s):  
Karen Lascelles ◽  
Lisa Marzano ◽  
Fiona Brand ◽  
Hayley Trueman ◽  
Rupert McShane ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Qualitative Study ◽  
Structured Interviews ◽  
History Of ◽  
Bipolar Type ◽  
Self Harm ◽  
And Function ◽  
Emotionally Unstable Personality Disorder ◽  
The Impact

ObjectiveIt is recognised that ketamine treatment can reduce suicidal ideation (SI) in people with depression, at least in the short term. However, information is lacking on patients’ perspectives on such effects. Studying these can contribute to greater understanding of the mechanisms underlying impact of ketamine treatment on SI. The aim of this study was to investigate patients’ reports of the impact of treatment on their SI, the duration of effects and possible mechanisms.Design and settingThis qualitative study consisted of semi-structured interviews with patients who had received ketamine treatment for depression. Interview data were analysed thematically.ParticipantsFourteen patients (8 females, 6 males, aged 24–64 years) who had received treatment with ketamine for treatment-resistant depression, and had SI at the initiation of treatment. Two participants also had a diagnosis of bipolar type 1 and two of emotionally unstable personality disorder. Eight had a history of self-harm.ResultsSI reduced following ketamine treatment in 12 out of 14 participants for periods of a few hours following a single treatment to up to three years with ongoing treatment. Reduction of SI was variable in terms of extent and duration, and re-emergence of suicidal thoughts often occurred when treatment ceased. Participants’ accounts indicated that reduced SI was associated with improved mood and reduced anxiety, as were clarity of thought, focus and concentration, and ability to function. Participants reported experiencing some or all of these effects in various orders of occurrence.ConclusionGenerally, ketamine treatment was experienced as effective in reducing SI, although duration of effects varied considerably. Patients’ perspectives indicated similarities in the mechanisms of reduction in SI, but some differences in their manifestation, particularly in relation to chronology. Experiences of this cohort suggest that reduced anxiety and improvement in ability to think and function were important mechanisms alongside, or in some cases independently of, improvement in mood. Further studies of patients’ experiences are required to gain enhanced understanding of the variability of effects of ketamine on SI and functionality.

An evaluation of a leadership development coaching and mentoring programme

2017 ◽  
Vol 30 (3) ◽  
pp. 309-329 ◽  
Author(s):  
Lyndsay Le Comte ◽  
Beverley McClelland
Keyword(s):  
Leadership Development ◽  
Distributed Leadership ◽  
Structured Interviews ◽  
Senior Staff ◽  
Content Type ◽  
Mixed Methods Approach ◽  
Group Coaching ◽  
Supportive Culture ◽  
The Impact ◽  
Practical Implications

Purpose The purpose of this paper was to determine the value and impact of the Leadership Development – Coaching and Mentoring Programme at Counties Manukau Health and understand how the skills gained are applied. Design/methodology/approach Mixed-methods approach including surveys of programme participants and senior staff and semi-structured interviews with programme participants. Findings The survey response rate was 24.4 per cent for programme participants and 30 per cent for senior staff. Eight programme participants participated in semi-structured interviews. Of the 70 programme participants, 69 utilised their learning from the programme; 45 of 70 changed their approach to managing staff; and 40 of 68 programme participants reported that meeting with peers for triad group coaching was the most challenging aspect of the programme. Key themes identified through interviews included: working with others; not owning others’ problems; professional support and development; coaching and mentoring; future participants. Practical implications The majority of participants changed their leadership behaviours as a result of the programme, which has resulted in improved communication, a more supportive culture and distributed leadership. These changes contribute to better patient care. Originality value There is a paucity of evidence in the literature about the impact of coaching and mentoring programme on leadership development and how the skills gained in such programmes are applied in practice in a healthcare context. This evaluation helps to address that gap.

Changing organisational culture: another role for self-advocacy?

2015 ◽  
Vol 20 (2) ◽  
pp. 69-76 ◽  
Author(s):  
Robin Miller
Keyword(s):  
Culture Change ◽  
Organisational Culture ◽  
Local Context ◽  
Advocacy Group ◽  
Advocacy Groups ◽  
Senior Managers ◽  
Self Advocacy ◽  
Content Type ◽  
Group Members ◽  
The Impact

Purpose – Improvements in organisational culture are a common recommendation of enquiries into system failure and an aspiration of policy. The purpose of this paper is to explore an initiative to change culture in a low-secure service through the introduction of a self-advocacy group. Design/methodology/approach – An independent evaluation was carried out by a university research team. A theory-based methodology was deployed with qualitative data gathered through observations, interviews and focus groups. Findings – Culture change was reported by senior managers and clinicians in relation to the transparency of the service, decision making regarding resources, and engagement of patients in redesign. Self-advocacy group members reported a different relationship with senior management which in turn enabled greater influence in the organisation. Achieving these impacts relied on independent and skilled external facilitation, support from senior managers, and a calm and democratic atmosphere in the meetings. Ward staff were kept at an arms-length from the group and were less certain that it had made any difference to the way in which the ward operated. Research limitations/implications – The research was only based in one organisation and the impacts of the initiative may vary with a different local context. Research in a wider sample of organisations and culture change initiatives will provide greater insights. Practical implications – Self-advocacy groups can lead to organisation culture change alongside benefits for individual group members but require funding, external and independent facilitation, and organisational endorsement and support. Originality/value – This paper adds to the limited literature regarding culture change in secure services and services for people with a learning disability in general and also to the understanding of the impact of self-advocacy groups.

scholarly journals “Tipping The Balance” – An Evaluation of COVID-19 Parenting Resources Developed and Adapted for Child Protection During Global Emergency Responses

2021 ◽  
Author(s):  
Lorraine Sherr ◽  
Helen Mebrahtu ◽  
Kasonde Mwaba ◽  
Nisso Nurova ◽  
Angelique Nicole Chetty ◽  
...  
Keyword(s):  
Child Protection ◽  
Qualitative Evaluation ◽  
Ease Of Use ◽  
School Closure ◽  
Local Context ◽  
Evidence Based ◽  
Structured Interviews ◽  
Children’S Behaviour ◽  
Future Direction ◽  
The Impact

Abstract Background: The advent of the COVID-19 pandemic presented many challenges for parenting. Parenting was severely affected by lockdown, school closure, illness, shortages, movement restrictions and the many sudden changes wrought by the global emergence of COVID-19. Responding to the need for a rapid emergency response to support parents and caregivers, a consortium of providers developed a suite of COVID-19 parenting resources based on evidence-based parenting interventions. Launched in March 2020, these were adapted for online use, with versions in over 100 languages, and the possibility for downloading, radio, and oral provision. A rapid qualitative evaluation initiative was conducted from September 2020 to February 2021 to inform the procedure, understand the impact and to drive future provision.Methods: The evaluation collected open-ended responses surveys (n=495 participants) and in-depth interviews with parents, providers and adolescent children (n=22) from 14 countries and one global source. Data were gathered on parenting challenges during COVID-19 and the utility of the COVID-19 parenting resources. In-depth, semi-structured interviews explored the same concepts and elaborating on challenges, utility, and recommendations for the future. Data were translated to English and coded in a hierarchy from basic, organising and global theme generation. Results: The parenting resources equipped parents with information and practices transforming everyday lives, interactions and the challenges from the parenting pressures. The tips provided prompts and permissions related to children’s behaviour, enabled communications and offered ways to reduce stress, monitor behaviour and navigate discipline challenges. The timeliness of the resources as well as the clarity and ease of use were seen as advantages. Future direction and possible hurdles related to adaptations needed according to recipient, child age, local context, culture and new challenges. Conclusions: Although limited by the timing and reach of the disseminated tips, overall findings point to the value and utility of this unprecedented global response to the COVID-19 pandemic. Results suggest that rapid provision of parenting resources at scale is feasible and of use and opens up a pathway for providing evidence-based interventions under COVID-19 constraints.Trial registration: N/A

scholarly journals Soil Quality in Agroecological Production Areas in Southern Brazil: Indicators Based on Farmers' Perception

2021 ◽  
Vol 9 (2) ◽  
pp. 96
Author(s):  
Jacir João Chies ◽  
Helvio Debli Casalinho ◽  
Lizete Stumpf ◽  
Marília Alves Brito Pinto ◽  
Leonir Aldrigui Dutra Junior
Keyword(s):  
Organic Matter ◽  
Soil Quality ◽  
Management Practices ◽  
Organic Matter Content ◽  
Matter Content ◽  
Southern Brazil ◽  
Structured Interviews ◽  
History Of ◽  
Production Areas ◽  
The Impact

Farmers' local knowledge about soil quality and management practices should be considered to assess the impact of agricultural technology packages on the environmental performance of agro-ecosystems. This study aimed to evaluate the soil quality under agroecological production in southern Brazil, which was considered of good quality by the farmers' perception. From August to November 2017, ten farms from Liberdade settlement were visited, and semi-structured interviews were conducted to collect information about soil and agricultural knowledge. “What does good quality soil mean? What cares for preserve soil quality? Does the soil location in landscape influence conservation practices?” were the questions asked. In May 2018, soil samples were collected from each area, and chemical, physical, and biological attributes were determined. All farmers mentioned the organic matter indicated good soil quality; however, the study showed that most soils have low content, a consequence of the annual tillage adopted by all farmers for the implantation of seeds crops; Farmers indicated that a good quality soil has "life" with the presence of organisms. In our study, a low population of mites and springtails in most areas was observed. Positive farmers’ perception about the organic matter content and soil organism’s presence in their agroecological production areas come from the degradation history of the areas, at the same time that they attribute improvements in soil quality due to the actions adopted over the 10 years of agroecological production.

Abstract 15730: Ankle-Brachial Index and Physical Function in Community-Based Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kunihiro Matsushita ◽  
Shoshana Ballew ◽  
Yingying Sang ◽  
Corey Kalbaugh ◽  
Laura Loehr ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Independent Living ◽  
Ankle Brachial Index ◽  
Poor Performance ◽  
Community Dwelling ◽  
Atherosclerosis Risk In Communities ◽  
Logistic Regression Models ◽  
History Of ◽  
The Impact

Background: Lower extremity peripheral artery disease (PAD), commonly defined by an ankle-brachial index (ABI) <0.9, increases mortality risk and also reduces physical function. All prior studies of the impact of PAD on objectively measured physical function have been in restricted populations with known PAD or physical inactivity, leaving uncertainty regarding its impact in the community. Methods: We studied 5,351 ARIC participants (age 71-90 years during 2011-2013) who underwent the assessment of ABI and the Short Physical Performance Battery (SPPB, 0-12 scale), a summary measure of physical function based on three domains (4-meter walk velocity, timed chair stands, and standing balance). Logistic regression models examined the association of ABI with poor physical function (SPPB score <6), adjusting for potential confounders including a history of other cardiovascular diseases. Results: There were 463 participants (8.2%) with ABI <0.9 and 506 participants (9.0%) with ABI ≥1.3, a potential manifestation of PAD reflecting noncompressible pedal arteries. Both ABI <0.9 and ≥1.3 were significantly and independently associated with higher odds of having poor physical function compared to those with a normal ABI (1.1-1.2). The 469 participants (8.8%) with a “borderline” low ABI (0.9-1.0) also demonstrated significantly poor physical function. Low ABI was significantly associated with poor performance in every SPPB domain, whereas none were statistically significant for high ABI. The results were largely consistent among those without a history of stroke or heart failure. Conclusion: In our population of community-dwelling older adults, ~25% had low, borderline low, or high ABI suggestive of PAD and demonstrated poorer physical function compared to those with normal ABI. Since physical function is a key element for independent living in older adults and several therapeutic options for PAD exist, our findings may have broad and important implications.

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